Abstract
Problem. Occasionally, a newborn is either premature or has a medical condition that requires admission to the Neonatal Intensive Care Unit (NICU). Joy can quickly turn to heartache or grave concern for the parents as well as the hospital staff. Admission to an NICU can cost more than $10,000 per day. Stays in the NICU can range from a couple of days to months. Insurance, either commercial or government-sponsored safety net, pays most of the cost of the admission. Purpose. The purpose of this research project was to assist government organizations and healthcare institutions in establishing directions for healthcare policy. As the United States implements the Patient Protection and Affordable Care Act, the results of this research project will provide valuable information. Methodology. This research project questioned if the patterns of insurance for NICU infants are similar to traditional norms for the State of California. A 2010 paper analyzed the 2006 data and quoted the payer mix as 59% commercially insured infants and 41% covered by a form governmental safety-net insurance. As California moves to implement the Patient Protection and Affordable Care Act, information on the insurance patterns will be used to predict costs and plan for services to care for these fragile infants. Findings. Results showed a significant change in the insurance patterns since 2006. There has been an increase in safety-net Medi-Cal and a decrease in commercially insured infants in an NICU. Significance was also demonstrated between 6 counties and the California statewide data, so planning health care in each county studied will need to combine autonomy and guidance to increase the commercially insured. Conclusion and Recommendations. Public administrators who manage healthcare organizations will find the results of this study as an indicator of possible policy directions. Planning of health care for these high-cost infants must be done not only for the acute admission and immediately after discharge but also to ensure appropriate outpatient care for major congenital complications and disorders, as well as increased educational needs. As the healthcare industry moves to comply with the Patient Protection and Affordable Care Act, research studies such as this will be valuable for program design.